Methodological instruction

to practical lesson of nurse-bachelour students

LESSON № 1

Theme 1. General illness development conformities to natural laws. Etiology and pathogenesis.

Theme 2. Heredity role in human pathology

Aim: To be able analyse lawfullness arise, development and diseases consequences. To study in the experiment action of decreased atmospheric pressure upon organism. To get acquainted with study and diagnostic methods of hereditary diseases.

Professional orientation of students. In everyday practical activity doctor always takes into account of illness nature and peculiarities of it course. This important for planning of prophylactic arrangements, diagnosis raising, selection of medical drugs. In illness is distinguished two process : а) damage property illness; b) physiological measure against illness, that is complex of protective compensatory-adaptation reactions. The protective reactions perform with nervous, endocrine, immune and other systems. With their help an organism resists to pathogenic factors and restores broken functions. We can train, to heighten these reactions, to make them more powerful and firm. For this make use of special loadings, tempering, physiotherapy procedures. By protective reactions one can be governed also by the medium of medical drugs. Aim of such arrangements – to raise individual organism resistance to action of harmful agents. During continuous evolution organism has adapted to normal atmospheric pressure. But in conditions of modern life man more often encounters with action of changed atmospheric pressure. This is related to production activity (fliers, cosmonauts, divers), sport (mountaineering). Action of changed atmospheric pressure upon organism is used in medicine for treatment (barotherapy). It is important to know, that durin rapid changing of atmospheric pressure complicated symptomocomplex occurs which is called barotrauma. In modern of contemporary war barotrauma can have wide spread owing to influence of shock wave.

Hereditary factors play an essential role in human pathology. Now is known about 2000 diverse hereditary diseases are known. 4 % of new-born suffer from these or other genetically conditioned defects. This testifies importance of ability to participate in exposure methods of hereditary diseases, study ways of their prophylaxіs and cure principles. Heredity pathology plays an important role in development mechanisms of such hereditary conditioned diseases, as atherosclerosis, essential hypertension, rheumatism, diabetes mellitus, gout.

Program of independent students preparation

Theme № 1 of practical lesson

1. Gist of experimental method	Definition a notion of “experiment” Peculiarities, significance and lacks of acute experiment Peculiarities of chronic experiment
2. General conceptions of illness	Definition of illness notion Looks on illness development Illness signs Illnesses classification Illness periods Illness ends Pathological process Pathological state

3. Notion about etiology and pathogenesis	Definition of notion “etiology" Definition of notion “pathogenesis" Main links of pathogenetic chain Definition of notion “compensatory-adaptative reactions” Types of compensatory-adaptative reactions Role of compensatory-adaptative reactions reactions in convalescence mechanisms
4. Classification of etiological disease factors	Definition of notion ” “cause” and “condition” The role of causes and conditions in beginning of desease External and internal pathogenetic factors Physical pathogenic factors
5. Influence of decreased atmospheric pressure upon organism	Man activity in conditions of decreased atmospheric pressure Mechanisms of action of decreased atmospheric pressure Manifestations of hypobaropathy
6. Influence of increased atmospheric pressure upon organism	Man activity in conditions of raised atmospheric pressure Mechanism of action of increased atmospheric pressure Manifestations of saturation and desaturation Use of oxygenation in medicine
7. Possibilities of prophylaxy of disorders, associated changes of barometric pressure	Organism defense during work in conditions of changed barometric pressure Preventing of the airembolism

Theme № 2 of practical lesson

1. Causes of hereditary diseases	Physical mutagenes Chemical mutagenes Biological mutagenes
2. Development mechanisms of hereditary diseases	Genome mutations Chromosome mutations Genes mutations
3. Inheritance types	Autosomal-dominant inheritance Autosomal-recessive inheritance Х- linked chromosome inheritance
4. Chromosome illnesses	Down’s illness Klinefelter’s syndrome Turner’s syndrome Х-trisomy syndrome Syndrome of catlike cry
5. Molecular hereditary illnesses	Phenylketonuria Albinism Alkaptonuria Galactosemia
6. Diagnostics methods of hereditary illnesses	Cytogenetic method Genealogical method Twins method Populational-statistic method Immunological method Dermatoglyphical method Experimental method

7. General principles of hereditary illnesses prevention	Guard of environment Forbidding of atomic weapon Increasing of safety of nuclear technologies Explanatory work among population Antenatal disclosure of hereditary anomalies Medical-genetic consultations
8. Cure principles of hereditary illnesses	Genes engineering Replacement therapy Removal of metabolite in front of blocked stage Compensation of metabolite after blocked stage Elimination of physical deffects

Standards of tests task and real-life situations

Theme № 1 of practical lesson

Tests tasks (Choose the correct answer).

1. During action of increased atmospheric pressure supplementary amount of gases dissolves in blood and organism tissues. This phenomenon is called - A. Hyperoxia B. Hypoxia C. Hypercapnia D. Saturation Е. Desaturation

2. Sudden death during dehermetization of cockpit at height 19000 m is rose owing to

A. Carbonic acid deficit B. Organism desaturation C. Gas embolism D. Oxygen deficit Е. Height meteorism

Real-life situations. Alpinists slowly сlimb on south side of Everest. It was sixth hours of ascending. General weakness was present. Breath became more difficult. There were palpitation. Pulse rate achieved to 100 beats for a minute. Dizziness, headache lowering of mood and appetite, meteorism were observed.

1.What was the direct cause of these disorders in the alpinists?

2.How this symptomatic complex is called?

3.What height were alpinists on?

4. What significance in this situation had increased breathing and cardiac rhythm?

Theme № 2 of practical lesson

Tests tasks (Choose the correct answer).

1. While examening a patient doctor turned mind to her low growth, wide shieldlike, insufficient physical and sexual development. External genitalia formed on feminine type, internal – underdeveloped. Barr body in cells of mouth mucous membrane was not determined. For what disease is it typical? A. Klinefelter’s syndrome B. Turner’s syndrome C. Х-trisomy syndrome D. Down’s illness Е. Pathau’s syndrome

2. What is the inheritance phenylketonuria?

A. Autosomal-recessive B. Autosomal-dominant C. Х- linked chromosome D. Y- linked chromosome Е. Type of incomplete dominanting

Real-life situations. Woman is heterozygous on phenylketonuria gene, and her husband is homozygous on normal alleles of this gene. 1. What is probability in this family of giving birth to a child sick with phenylketonuria? 2. Define probability of a phenylketonuria display, if wife is heterozygous on given gene.

Answers to tests and to questions of real-life situations

Theme № 1 of practical lesson.

Tests tasks: 1 – D, 2 – C.

Real-life situations: 1. Lowering of partial oxygen pressure. 2. Hypobaropathy of mountain disease. 3. About 5000-6000 m. 4. Compensation significance.

Theme № 2 of practical lesson.

Tests tasks: 1 – В, 3 - А.

Real-life situations: 1. All of children will be healthy, but 50 % will be phenylketonuria gene carriers. 2. 25 %.

Sources of the information

BASIC:

1.      Pathological physiology / Yu.I. Bondarenko, M.R. Khara, V.V. Faifura, N. Ya. Potikha. ‑ Ternopil: Ukrmedkniga, 2006. – 312 p.

2.      Methodological instructions

ADDITIONAL:

1. Robbins basic pathology, 7/e / Kumar et al. – Indian reprint, 2004. – 873 p.

Method of implementation of practical work

І. Theme №1 of practical lesson

Work 1. Experiment: Action of decreased atmospheric pressure upon organism of a rat

Place animal under glass bell. Acquaint with condition of animal before experiment beginning (behavior, skin colour, breathing rate, reaction on sound irritant). By the medium of pump gradually diminish pressure under bell. Observe change of animal condition. Clock each supervision. After beginning of first cramps in animal gradually let air in and observe reneval of organism functions.

Write down the experiment results in the table and protocol of experiment according to scheme:

Experience minute scheme:

1.      Protocols number, date

2.      Theme, (topic) of the lesson

3.      Title of experiment (The name of experiment)

4.      Materials and methods

5.      Experiments results and their discussion

6. Conclusion

Pressure	Height	General animal condition
		breathing rate	behavior	sound irritant	skin colour
1 atm	0 m
0,69 atm	3000 m
0,46 atm	6000 m
0,30 atm	9000 m
0,18 atm	12000 m

Durind discussion of results we must answer for questions:

1. What stages can be distinguished in this symptomatic complex?

2. Describe each stage.

3. Explain mechanisms of exposed disorders.

ІІ. Theme № 2 of practical lesson

Work 2. To analyse chromosome sets and to make conclusions, for what diseases they are characterized, ground the thought

Work 3. To analyse the genealogical tables of pedigree with hereditary diseases (figures 7-17) and to define type of their inheritance ground the thought

Work 4. To make conclusions of correlative role heredity and external environment in development of diseases. ground the thought

According to results of practical work №№ 2, 3, 4 make up protocol according to analogical scheme

Seminar discussion of theoretical questions

1.      Gist of experimental method

2. General conceptions of illness

3.      Notion about etiology and pathogenesis

4. Classification of etiological disease factors

5.      Influence of decreased atmospheric pressure upon organism

6. Influence of increased atmospheric pressure upon organism

7.      Possibilities of prophylaxy of disorders, associated changes of barometric pressure

1.      Causes of hereditary diseases

2.      Development mechanisms of hereditary diseases

3.      Inheritance types

4.      Chromosome illnesses

5.      Molecular hereditary illnesses

6.      Diagnostics methods of hereditary illnesses

7.      General principles of hereditary illnesses prevention

8.      Cure principles of hereditary illnesses

Students must know:

1. Definition of notions: illness (desease), pathological process, pathological state, etiology, pathogenesis

2. Illnesses classification

3. Illness periods

4. Illness ends

5. Types of compensate-adaptation reactions

6. Classification of etiological factors of illness

7. Pathogenic influence of atmospheric pressure upon organism

8. Pathogenic influence of increased atmospheric pressure upon organism

9. Prophylaxis of disorders, related to change of atmospheric pressure

10. Causes of hereditary disorders in people

11. Beginning mechanisms of hereditary diseases

12. Study methods and diagnostic of hereditary diseases

13. General preventson principles and cure of hereditary diseases

Students should be able to :

1. Explain pathogenic influence decreased and increased atmospheric pressure upon organism

2. Distinguish the stages of experimental mountain illness

3. Evaluate change of the breathing, cardiac activity, reflex reactions and behavior due to climb on height and diving

4. Explain pathogenesis of aeroembolism

5. Define reactions of organism, which have compensatory importance at influence of changed atmospheric pressure upon organism

6. Reproduce influence of decreased atmospheric pressure upon organism of rat in experiment and та analyse experimental data

7. Diagnose of the chromosome diseases (Down’s illness Klinefelter’s syndrome Turner’s syndrome ) by cariograms analysis

8. Analyse the genealogical cards, diagnose hereditary diseases and lawfullness of their transmission

9. Evaluate correlative role of heredity and external environment in arising of illnesses on twins sickness rate (analysis of the concordity index)

10. Ground prophylaxis method and cure of hereditary diseases

Methodological instruction made by prof. Yu.I. Bondarenko, as. prof. N.Ya. Potikha.

The methodological instruction was discussed

and confirmed at the Department sitting

“29” August 2013. Minute № 2.